- Email: [email protected]
The relationship between transversus abdominis thickness and abdominal pressure during successful and unsuccessful abdominal draw-in maneuvers
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WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642
the affected side showed greater values in the insole condition than in the barefoot condition. The total angles of flexion of the hip and knee were also significantly greater with the insole than with shoes only. The hip extension angular impulse of the 10% period of the initial landing was significantly greater in the insole condition than in the barefoot condition. No significant difference was found among the conditions for muscle activity of the affected side. By wearing the insoles, the valgus angle was reduced in the heel-leg angle. Significant and negative correlation was found between the amount of change by wearing insoles in the total angle of flexion of the hip and knee at initial contact and ankle dorsiflexion angle of the affected side. Conclusion(s): Results suggest that insole intervention can be effective against risk in sagittal plane kinematics and kinetics on the affected side of patients who have undergone ACLR. These effects might result from control of the calcaneus sustentaculum tali. Insole intervention might be particularly effective in cases of decreased ankle dorsiflexion. Implications: Results presented herein suggest that insole intervention with the purpose of correcting heel-leg angle for actual patients with ACLR is particularly effective to modify the sagittal plane biomechanics. Keywords: Anterior cruciate ligament reconstruction; Insoles; Biomechanics Funding acknowledgements: None. Ethics approval: This study was approved by the ethical boards of Yamagata Prefectural University of Health Sciences and Yamagata Saisei Hospital. http://dx.doi.org/10.1016/j.physio.2015.03.1418 Research Report Poster Presentation Number: RR-PO-08-24-Sun Sunday 3 May 2015 13:00 Exhibit halls 401–403 THE RELATIONSHIP BETWEEN TRANSVERSUS ABDOMINIS THICKNESS AND ABDOMINAL PRESSURE DURING SUCCESSFUL AND UNSUCCESSFUL ABDOMINAL DRAW-IN MANEUVERS H. Sugimoto 1,2 , K. Momose 3 1 Matsumoto
Medical Center, Chushin-Matsumoto Hospital, Matsumoto, Japan; 2 Graduate School of Medicine, Shinshu University, Health Sciences, Matsumoto, Japan; 3 Shinshu University, Physical Therapy, Matsumoto, Japan Background: It has been recommended that one of the possible treatment for low back pain is the abdominal drawin maneuver (ADIM) produced by selective activation of transversus abdominis (TrA). Ultrasound imaging (USI) or pressure biofeedback unit (PBU) for ADIM has been recommended. The validity of USI is high since it is one of the
methods that can actually carry out imaging of the muscle thickness. However, relationships between muscle thickness and changes in abdominal pressure are unknown. We hypothesize that successful selective contraction (SSC) of TrA during ADIM may be negatively correlated with changes in abdominal pressure. We also hypothesize that unsuccessful selective contraction (USSC) of TrA during ADIM may not be correlated with changes in abdominal pressure. Purpose: This study aimed to investigate the relationships between transversus abdominis thickness from USI and abdominal pressure changes from the PBU during ADIM. Methods: Eighteen male healthy volunteers participated in this study. The measurement was performed with subjects in prone position. The transducer of USI was positioned at the intersection of anterior axillary line with the midline between the last rib and ilium on the mid-axillary axis. The inflatable bag of PBU, which was used to measure abdominal pressure, was placed centrally beneath the abdomen with the lower edge at the level of the anterior superior iliac spines. Subjects were given standard instructions as follows: “take your belly button up maximally and in towards your spine, and don’t move pelvic or spinal position” Muscle thickness and abdominal pressure were measured three times during both conditions at end-expiration of rest and during ADIM. Muscle thickness data were normalized by calculating increase in thickness from resting thickness. Abdominal pressure data were normalized by calculating increase or decrease in pressure from resting pressure. Subjects were classified into 2 groups as follows: “SSC” group which is defined as subjects whose muscle thickness of TrA during ADIM increased and muscle thickness of EO during ADIM did not increase; and “USSC” group which is defined as subjects are not classified as SSC. To examine the relationships of SSC and USSC between TrA muscle thickness and abdominal pressure Pearson product–moment correlation coefficient was employed. Statistical significance was set at p < 0.05. Results: USSC did not reveal correlations with abdominal pressure changes (r = 0.13, p = 0.52). SSC reveal correlations with abdominal pressure changes (r = 0.42, p = 0.02), however, the result of this study was positive correlation. Conclusion(s): The results suggested that correlation between TrA thickness and abdominal pressure in SSC was not negative in maximal ADIM. It is difficult to use abdominal pressure induced PBU for successful ADIM, because there is positive correlation with TrA thickness and abdominal pressure. However, it is unknown that correlation between TrA thickness and abdominal pressure in SSC was not negative. Implications: Abdominal pressure during prone position measurement of PBU may be not suitable as feedback for ADIM. On the other hand, USI for which imaging of the deep and surface abdominal muscles is actually carried out, may be a more suitable and preferred method. Keywords: Transversus abdominis muscle; Ultrasound imaging; Pressure biofeedback unit
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642
Funding acknowledgements: Nil. Ethics approval: Ethics committee of Shinshu University. http://dx.doi.org/10.1016/j.physio.2015.03.1419 Research Report Poster Presentation Number: RR-PO-13-08-Sun Sunday 3 May 2015 13:00 Exhibit halls 401–403 IS EXERCISE THERAPY EFFECTIVE IN THE OLDER PEOPLE? A SYSTEMATIC REVIEW M.S. Sulaiman 1 , F. Nizamuddin 2 , T.B. Chai Sunny 3 1 Ang
Mo Kio-Thye Hua Kwan Hospital, Allied Health Department, Singapore, Singapore; 2 Singapore General Hospital, Department of Physiotherapy, Singapore, Singapore; 3 Tan Tock Seng Hospital, Department of Physiotherapy, Singapore, Singapore Background: Aging is strongly associated with impaired mobility and decreased physical functional performance. Exercise has been shown to improve physical function in frail older adults; however, the effects of exercise may vary with degree of frailty, the format and intensity of the exercise intervention, and level of supervision. As such, we performed a recent systematic review to look for conclusive evidence on the effect of exercise intervention in improving function in elderly. Purpose: Physical inactivity has shown a decrease in function for elderly population. Physical activity has been encouraged to induce physiological and physical benefit but the effect is limited to energy expenditure. Physical activity if structured [Exercise] has shown an objective measurement for the component of Health related and skill related fitness thereby improving the physical function in elderly population. Methods: This systematic review aims to summarize and evaluate the structure, as well as results of the intervention. Four databases (EBSCO MEDLINE Plus with Full Text, EBSCO CINAHL Plus with Full Text, ScienceDirect and Google scholar, have been searched, generating 32 relevant studies. Of which 18 Randomised Control Trials (RCTs), 1 Quasi-experimental study, 9 Cohort studies, 1 Cross-sectional study and 3 Before-and-after studies satisfied our objectives. Results: The results were grouped according to whether they are significant based on p-values/effect size and tabulated. These information was compiled into clustered bars according to the number of significant and insignificant results based on outcome measure emphasis on impairment, disability and function on each study. Conclusion(s): The review has shown that if exercise therapy is structured, is effective in improving function, addressing impairments and disabilities in the elderly.
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Implications: The rehabilitation exercise performed in Physical Therapy Department need to be structures to decrease morbidity through the change in biochemical, physiological, physical and psychological processes. Keywords: Geriatrics; Exercise therapy; Systematic review Funding acknowledgements: No funding was provided. Ethics approval: No ethical approval done due to unavailable IRB committee. http://dx.doi.org/10.1016/j.physio.2015.03.1420 Research Report Poster Presentation Number: RR-PO-99-25-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 BODY SEGMENT INERTIAL PARAMETERS ESTIMATION OF THE LOWER TRUNK OF PREGNANT JAPANESE WOMEN AIMED AT PRACTICAL USING IN MOTION ANALYSIS Y. Sunaga 1,2 , M. Anan 3 , M. Takahashi 3 , K. Shinkoda 3 1 Saitama
Prefectural University, Physical Therapy, Faculty of Health and Social Services, Koshigaya, Japan; 2 Hiroshima University, Graduate School of Health Sciences, Health Science Major, Division of Physical Therapy & Occupational Therapy Sciences, Hiroshima, Japan; 3 Hiroshima University, Department of Biomechanics, Institute of Biomedical & Health Sciences, Hiroshima, Japan Background: Accurate body segment inertial parameters (BSPs) are essential for the motion analysis, but previous studies have never reported about BSPs of pregnant Japanese women. It may be inappropriate to apply BSPs different from that of pregnant Japanese women without consideration for physical constitution. Purpose: We aimed to estimate BSPs of pregnant Japanese women for practical use in motion analysis and predict the changes of the lower trunk segment mass from the original physical constitution. Methods: Eight pregnant women and seven nulliparous women were recruited in this study. Pregnant women were examined around 16th (exam 1), 24th (exam 2) and 32nd (exam 3) week of gestation. 24 infrared reflective markers were attached to the lower trunk and lower extremities of the subjects, and their standing positions were captured by eight infrared cameras and identified coordinates of the markers using motion analysis software. The lower trunk was divided into six hexahedral parts, each consisting of six tetrahedrons and calculated the mass, center of mass (COM), moment of inertia and radius of gyration of each part. These parameters were resultant and the ratio of the lower trunk segment mass to the body mass, the ratio of the distance of the lower
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642
the affected side showed greater values in the insole condition than in the barefoot condition. The total angles of flexion of the hip and knee were also significantly greater with the insole than with shoes only. The hip extension angular impulse of the 10% period of the initial landing was significantly greater in the insole condition than in the barefoot condition. No significant difference was found among the conditions for muscle activity of the affected side. By wearing the insoles, the valgus angle was reduced in the heel-leg angle. Significant and negative correlation was found between the amount of change by wearing insoles in the total angle of flexion of the hip and knee at initial contact and ankle dorsiflexion angle of the affected side. Conclusion(s): Results suggest that insole intervention can be effective against risk in sagittal plane kinematics and kinetics on the affected side of patients who have undergone ACLR. These effects might result from control of the calcaneus sustentaculum tali. Insole intervention might be particularly effective in cases of decreased ankle dorsiflexion. Implications: Results presented herein suggest that insole intervention with the purpose of correcting heel-leg angle for actual patients with ACLR is particularly effective to modify the sagittal plane biomechanics. Keywords: Anterior cruciate ligament reconstruction; Insoles; Biomechanics Funding acknowledgements: None. Ethics approval: This study was approved by the ethical boards of Yamagata Prefectural University of Health Sciences and Yamagata Saisei Hospital. http://dx.doi.org/10.1016/j.physio.2015.03.1418 Research Report Poster Presentation Number: RR-PO-08-24-Sun Sunday 3 May 2015 13:00 Exhibit halls 401–403 THE RELATIONSHIP BETWEEN TRANSVERSUS ABDOMINIS THICKNESS AND ABDOMINAL PRESSURE DURING SUCCESSFUL AND UNSUCCESSFUL ABDOMINAL DRAW-IN MANEUVERS H. Sugimoto 1,2 , K. Momose 3 1 Matsumoto
Medical Center, Chushin-Matsumoto Hospital, Matsumoto, Japan; 2 Graduate School of Medicine, Shinshu University, Health Sciences, Matsumoto, Japan; 3 Shinshu University, Physical Therapy, Matsumoto, Japan Background: It has been recommended that one of the possible treatment for low back pain is the abdominal drawin maneuver (ADIM) produced by selective activation of transversus abdominis (TrA). Ultrasound imaging (USI) or pressure biofeedback unit (PBU) for ADIM has been recommended. The validity of USI is high since it is one of the
methods that can actually carry out imaging of the muscle thickness. However, relationships between muscle thickness and changes in abdominal pressure are unknown. We hypothesize that successful selective contraction (SSC) of TrA during ADIM may be negatively correlated with changes in abdominal pressure. We also hypothesize that unsuccessful selective contraction (USSC) of TrA during ADIM may not be correlated with changes in abdominal pressure. Purpose: This study aimed to investigate the relationships between transversus abdominis thickness from USI and abdominal pressure changes from the PBU during ADIM. Methods: Eighteen male healthy volunteers participated in this study. The measurement was performed with subjects in prone position. The transducer of USI was positioned at the intersection of anterior axillary line with the midline between the last rib and ilium on the mid-axillary axis. The inflatable bag of PBU, which was used to measure abdominal pressure, was placed centrally beneath the abdomen with the lower edge at the level of the anterior superior iliac spines. Subjects were given standard instructions as follows: “take your belly button up maximally and in towards your spine, and don’t move pelvic or spinal position” Muscle thickness and abdominal pressure were measured three times during both conditions at end-expiration of rest and during ADIM. Muscle thickness data were normalized by calculating increase in thickness from resting thickness. Abdominal pressure data were normalized by calculating increase or decrease in pressure from resting pressure. Subjects were classified into 2 groups as follows: “SSC” group which is defined as subjects whose muscle thickness of TrA during ADIM increased and muscle thickness of EO during ADIM did not increase; and “USSC” group which is defined as subjects are not classified as SSC. To examine the relationships of SSC and USSC between TrA muscle thickness and abdominal pressure Pearson product–moment correlation coefficient was employed. Statistical significance was set at p < 0.05. Results: USSC did not reveal correlations with abdominal pressure changes (r = 0.13, p = 0.52). SSC reveal correlations with abdominal pressure changes (r = 0.42, p = 0.02), however, the result of this study was positive correlation. Conclusion(s): The results suggested that correlation between TrA thickness and abdominal pressure in SSC was not negative in maximal ADIM. It is difficult to use abdominal pressure induced PBU for successful ADIM, because there is positive correlation with TrA thickness and abdominal pressure. However, it is unknown that correlation between TrA thickness and abdominal pressure in SSC was not negative. Implications: Abdominal pressure during prone position measurement of PBU may be not suitable as feedback for ADIM. On the other hand, USI for which imaging of the deep and surface abdominal muscles is actually carried out, may be a more suitable and preferred method. Keywords: Transversus abdominis muscle; Ultrasound imaging; Pressure biofeedback unit
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642
Funding acknowledgements: Nil. Ethics approval: Ethics committee of Shinshu University. http://dx.doi.org/10.1016/j.physio.2015.03.1419 Research Report Poster Presentation Number: RR-PO-13-08-Sun Sunday 3 May 2015 13:00 Exhibit halls 401–403 IS EXERCISE THERAPY EFFECTIVE IN THE OLDER PEOPLE? A SYSTEMATIC REVIEW M.S. Sulaiman 1 , F. Nizamuddin 2 , T.B. Chai Sunny 3 1 Ang
Mo Kio-Thye Hua Kwan Hospital, Allied Health Department, Singapore, Singapore; 2 Singapore General Hospital, Department of Physiotherapy, Singapore, Singapore; 3 Tan Tock Seng Hospital, Department of Physiotherapy, Singapore, Singapore Background: Aging is strongly associated with impaired mobility and decreased physical functional performance. Exercise has been shown to improve physical function in frail older adults; however, the effects of exercise may vary with degree of frailty, the format and intensity of the exercise intervention, and level of supervision. As such, we performed a recent systematic review to look for conclusive evidence on the effect of exercise intervention in improving function in elderly. Purpose: Physical inactivity has shown a decrease in function for elderly population. Physical activity has been encouraged to induce physiological and physical benefit but the effect is limited to energy expenditure. Physical activity if structured [Exercise] has shown an objective measurement for the component of Health related and skill related fitness thereby improving the physical function in elderly population. Methods: This systematic review aims to summarize and evaluate the structure, as well as results of the intervention. Four databases (EBSCO MEDLINE Plus with Full Text, EBSCO CINAHL Plus with Full Text, ScienceDirect and Google scholar, have been searched, generating 32 relevant studies. Of which 18 Randomised Control Trials (RCTs), 1 Quasi-experimental study, 9 Cohort studies, 1 Cross-sectional study and 3 Before-and-after studies satisfied our objectives. Results: The results were grouped according to whether they are significant based on p-values/effect size and tabulated. These information was compiled into clustered bars according to the number of significant and insignificant results based on outcome measure emphasis on impairment, disability and function on each study. Conclusion(s): The review has shown that if exercise therapy is structured, is effective in improving function, addressing impairments and disabilities in the elderly.
eS1455
Implications: The rehabilitation exercise performed in Physical Therapy Department need to be structures to decrease morbidity through the change in biochemical, physiological, physical and psychological processes. Keywords: Geriatrics; Exercise therapy; Systematic review Funding acknowledgements: No funding was provided. Ethics approval: No ethical approval done due to unavailable IRB committee. http://dx.doi.org/10.1016/j.physio.2015.03.1420 Research Report Poster Presentation Number: RR-PO-99-25-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 BODY SEGMENT INERTIAL PARAMETERS ESTIMATION OF THE LOWER TRUNK OF PREGNANT JAPANESE WOMEN AIMED AT PRACTICAL USING IN MOTION ANALYSIS Y. Sunaga 1,2 , M. Anan 3 , M. Takahashi 3 , K. Shinkoda 3 1 Saitama
Prefectural University, Physical Therapy, Faculty of Health and Social Services, Koshigaya, Japan; 2 Hiroshima University, Graduate School of Health Sciences, Health Science Major, Division of Physical Therapy & Occupational Therapy Sciences, Hiroshima, Japan; 3 Hiroshima University, Department of Biomechanics, Institute of Biomedical & Health Sciences, Hiroshima, Japan Background: Accurate body segment inertial parameters (BSPs) are essential for the motion analysis, but previous studies have never reported about BSPs of pregnant Japanese women. It may be inappropriate to apply BSPs different from that of pregnant Japanese women without consideration for physical constitution. Purpose: We aimed to estimate BSPs of pregnant Japanese women for practical use in motion analysis and predict the changes of the lower trunk segment mass from the original physical constitution. Methods: Eight pregnant women and seven nulliparous women were recruited in this study. Pregnant women were examined around 16th (exam 1), 24th (exam 2) and 32nd (exam 3) week of gestation. 24 infrared reflective markers were attached to the lower trunk and lower extremities of the subjects, and their standing positions were captured by eight infrared cameras and identified coordinates of the markers using motion analysis software. The lower trunk was divided into six hexahedral parts, each consisting of six tetrahedrons and calculated the mass, center of mass (COM), moment of inertia and radius of gyration of each part. These parameters were resultant and the ratio of the lower trunk segment mass to the body mass, the ratio of the distance of the lower